Wyatt Garab named children hospital's Child of the Year

Sunday

Feb 5, 2017 at 1:00 PM

Tiffanie DiDonato

It’s a humid July night, and 6-year-old Wyatt Garab is relaxing on his living room floor while playing on his iPad. His mom, Courtney Garab, is nursing her 3-week-old baby, Corbin, on the couch; while Sawyer, the family’s middle child, is happily next to her. And Wyatt’s dad, Grant Garab, a staff sergeant in the Marine Corps, is relishing the Thursday night off of duty with his family. It’s 6 p.m.

When the air cooled, they were all supposed to go to the park. But, without warning Wyatt jumps up clutching the right side of his head.

“It hurts really bad!” he exclaimed. “My head!”

Figuring the pain is related to a migraine, his dad administered some Tylenol and suggested bringing Wyatt upstairs to rest. The whole ordeal seemed strange, though, out of the blue. Wyatt hadn’t had a migraine before. And when Wyatt couldn’t even walk up the stairs on his own, both Courtney and Grant found reason to believe something more may be happening. The pain, Courtney Garab described, struck Wyatt that night in spurts. It would go then come back again and with vengeance. Even once Wyatt was tucked into bed with the lights out the spasms showed no mercy.

“Try to calm down,” his dad said, trying to soothe his son. And then Wyatt responded in the most unusual way, uttering a sentence that made no sense at all.

“I can’t calm down, you won’t sing me a lullaby,” he said. It wasn’t long after those words that Wyatt began to projectile vomit.

“He had this look in his eyes — he wasn’t looking at us but through us,” his mom described. “We immediately called the ambulance.”

Their quiet mid-summer’s night had officially turned into a real-time nightmare. The EMTs (along with two police officers) arrived just as Wyatt began to foam at the mouth while his left side went completely limp.

The family would split up — Grant would ride along in the ambulance while Courtney would gather what she could for the children and meet them at the Onslow Memorial Hospital. Inside the ambulance, Wyatt’s condition rapidly worsened. His dad assisted with prying Wyatt’s mouth wide open as he simultaneously seized and vomited.

Once Courtney pulled into the parking lot, Grant approached and told her to sit back down. Doctors discovered Wyatt’s brain was bleeding. This would be the first time the Garab family would hear the term aneurysm applied to their son.

The diagnosis

“I remember just screaming,” she recalled. “I remember crying out, ‘Why?! He had no injury! He was just fine! Why is his brain bleeding? How in the world is this happening?’ It was all hard to process.”

And then, she said, the thought no parent ever wants to ponder entered her heart: Will I be that parent who loses a child?

Stabilized, sedated and intubated to a mobile monitor, Wyatt was then life-flighted to James and Connie Maynard Children’s Hospital at Vidant Medical Center in Greenville. “It was the longest car ride my husband and I ever had to make. I didn’t know at that point if he was even still alive. Most of the ride to the hospital, though, was done in silence. We didn’t know what to say. Or do. All we wanted to do was cry.”

Seconds felt like minutes. Minutes felt like hours. Hours felt like days. Both Grant and Courtney mulled over their family history. There was no record of anyone on either sides ever having a brain aneurysm or even brain tumors.

Admittedly, they both knew nothing about brain aneurysms as a whole. They mistakenly assumed what so many of others do: It happens only to adults. But, children? Is it possible? And they traced over Wyatt’s activities: He didn’t fall and hurt his head. He didn’t suffer any prior injuries. Nor was he diagnosed with any disorders — all things that could have led to a cranial bleed. To them, none of it made sense.

And all of it made them question what exactly a brain aneurysm is. How is it caused?

A brain aneurysm

As WebMD describes it, an aneurysm begins with a bloated, weak area in the wall of an artery that supplies blood to the brain. Many times, a brain aneurysm causes no symptoms at all and thus goes unnoticed; but in other rare cases, the brain aneurysm will rupture, freeing blood into the skull and triggering a stroke. The result is called a subarachnoid hemorrhage. The most common place for brain aneurysms is at the base of the brain in the network of blood vessels, called the circle of Willis. According to the Department of Neurosurgery at Columbia University Medical Center, these brain aneurysms are more commonly found in individuals through their 40s or 50s. But there are also even rarer conditions where they can occur in children without absolute explanation.

The Department of Neurosurgery at Columbia University had more to say about pediatric brain aneurysms on their website.

“The chief symptom of a ruptured aneurysm is usually a complaint of ‘the worst headache of my life’ in adults or children old enough to give a good description. It is often associated with vomiting, a stiff neck, and light bothering the eye. Depending on such factors as the location of the aneurysm and the amount of blood in and around the brain, you can also see neurologic symptoms.”

There is upwards of a 50-percent death rate in those with a ruptured aneurysm.

In Wyatt’s case, he also developed a blood clot along with his ruptured aneurysm. It compounded matters, but also seemed to buy him a bit more time.

Waiting for news

In Greenville, both Grant and Courtney waited for 40 minutes inside a conference room for doctors to speak to them.

“I broke down. I prayed, literally begged for Wyatt to be OK,” Courtney remembered. Her voice pausing for a moment, maybe struggling, to keep an unmoved tone in front of her children. She’s told this story numerous times, so it’s OK, she assures me.

“I...It was still a lot to process. You feel like you’re not even inside your body. It’s the most bizarre feeling in the world. When others talk about heartbreak, I didn’t know what that felt like until I almost lost my child. My heart, my chest, literally hurt. It brought me to my knees. All the while, I still had to breastfeed and care for my infant. It’s all I could do,” she continued.

Finally, Dr. Kanaan, a neurosurgeon, walked in. In his hand, a consent form. He confirmed, Wyatt’s aneurysm ruptured on the right side of his brain.

“He told us, ‘Your son has a lot of swelling and pressure on his brain and what I need to do is get the fluid off his brain and relieve the pressure.’” Garab said. “And in a weird way, it was good to hear it, because it was then we knew he was still alive. But, time was crucial.”

The first step in what would be a long arduous process was immediately inserting an EVD (External Ventricular Drain) tube inside of Wyatt’s head. The first time Grant and Courtney would again lay eyes on their son since innocently playing on his tablet in their family living room was at 1 a.m. Friday. It is an image permanently carved into her memory.

“All I could do was sit there and look at him. The nurses spoke of how handsome he was and they were fighting tears. But, they hadn’t seen his bright blue eyes, because he was put to sleep. He...” her voice trailed off. “.... He looked peaceful despite his face, his lips, everything being swollen shut. I couldn’t believe how our lives turned upside down in a matter of seconds.”

By 8 a.m. Friday morning, doctors and nurses surround the bed along with an anesthesiologist. They reviewed their plan of action to save Wyatt’s life. First, Dr. Kanaan would perform a procedure called endovascular coiling. During endovascular coiling, a catheter is fished through the groin toward the brain up into the artery containing the aneurysm. Though one of the most minimally invasive procedures, it does possess a 10-percent risk of stroke. Next, Dr. Smith, a specializing pediatric neurosurgeon, would perform a craniotomy to remove the blood clot.

These two procedures, Courtney described as a “double-edged sword.” Time is crucial, but at the same time they have to take their time. And, again, all anyone could do was wait.

For the next eight hours, family would flood in from Rome, Georgia. Both Grant and Courtney would make the hard decision to place the care of their two children in the hands of their grandparents. Dividing the family was not their first choice, but seemingly their only one. Then the Garab family found themselves back in that cold conference room. But they would get the news they desperately needed to hear: Wyatt survived both procedures. The next few days, however, would be critical. And then they were presented with another seemingly impossible bitter pill to swallow: There is the risk Wyatt may suffer from brain damage.

“When we went to his side after surgery, I couldn’t see his blonde hair anymore. His head was all bandaged in white wraps. There were tubes in his mouth, IVs everywhere and you can’t help but ask, ‘What does it look like under all that white?’ To this day, I can still hear the monitors. And I can’t stand the smell of hand sanitizer. It will bring me back to the hospital,” she said. “I just kept asking, Have you seen children survive this? Have you seen other children wake up? Would he be Wyatt again?”

It would be days until Garab would receive the answers she so desperately needed. In the meantime, they found solace within the motions of routine. Doctors and nurses would do rounds. And both she and Grant would do shifts by Wyatt’s side. They would read, turn on music and put on superhero movies so he could hear his favorite characters battle evil and triumph over adversity. Balloons of every shape and size and color filled his room and so, too, did a giant cardboard cut-out of Captain America. And then there was the suggestion to begin a gofundme page. Within 24 hours it reached $12,000. After a few days thanks to the generosity of friends, family and people they didn’t even know, it reached $18,000. The Garab family no longer had to raid their savings or worry about the hotel and food expenses. They were able to concentrate on Wyatt.

Road to recovery

On the 10th day, doctors took Wyatt’s breathing tube out and let him breathe on his own. It was a massive milestone. The next few days, Wyatt’s prognosis improved dramatically. He began to squeeze hands, slightly opened his eyes and then started to communicate. He’d raise his tiny right hand (his left side paralyzed) and give a thumbs up or sign I love you. Throughout, his mom says she could tell he was in a lot of pain. It was small baby steps relearning all the motor skills he once did with ease before the aneurysm. But, day after day he would push through as doctors would monitor for vasospasms, or a “clamping down” of the blood vessels around the site of the aneurysm that can lead to a decrease in the blood supply to part of the brain or stroke.

After 15 days in the Pediatric Intensive Care Unit, Wyatt was well enough to be moved to the pediatrics floor where he would stay for one week. During that time, Garab received the answer she was longing for. While she sifted through a pile of DVDs, Wyatt called out, “Ant Man.”

“I thought, ‘Oh-my-gosh! You’re there! You’re really there! It’s you!’ And I began to notice, day by day one more medication was taken away. And then another. Until soon there were only a few things left attached to him. He had to relearn how to chew, to swallow, use the bathroom and sit up on his own. A long way considering it took three people to assist him in giving him a bath. But, he did it day by day.”

Eventually, Wyatt even began to use his iPad again and remembered his password, too.

Wyatt spent 49 days in the hospital. Of those 49 days, 26 were spent “practically living in rehab,” his mom said. Wyatt fought through fevers, scared off infections and wrestled keeping his blood pressure at a normal level. Then on Aug. 31 Wyatt was ready to go home again and he walked out the hospital doors. The wheelchair the hospital provided remains inside the family garage covered in spider webs — a testament to sheer will and determination.

It should be of no surprise that he was nominated for The Child of the Year for the James and Connie Maynard Children’s Hospital at Vidant Medical Center in Greenville, later clutching the title as the poster child for the Children’s Miracle Network of Greenville.

A pretty good big brother

Today, Wyatt still goes through occupational therapy and physical therapy. The only deficit, if you even want to call it such, is on his left foot he struggles to wiggle his toes on command and has a little bit of a limp. But, that doesn’t stop him from running. In fact, our planned interview took much longer than either Wyatt’s parents or I expected, because happily we waited for Wyatt to stop playing outside.

“I no longer take the littlest things for granted,” Courtney says. “My biggest accomplishment is being a mom. Life is short. It can change in a blink of an eye. I want others to pause a moment. To take the extra two minutes to help your child get dressed, enjoy them playing outside, be a part of something your kids are doing for five minutes.

“It doesn’t matter however long it takes, because that can be taken away from you in an instant. I have a newfound respect for nurses, doctors — everyone in the hospital. And I’ve tried to track down everyone involved in our journey, so I could hug them.”

There are still moments, she tells me, where she breaks down. Like Wyatt, Garab will have to travel a long road to learn how to cope with all that their family has been through. It’s still very much just one day at a time. But, she reminds herself of how far Wyatt has come. How far they all have come. And she bears witness to Wyatt’s unyielding strength and fortitude. And relishes in every moment — watching her children play, have popsicles and enjoy chocolate milk. Those things bring her solace.